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PROOF OF INSURANCE (2020) CLOSED 0 DATE(MMIDDIYYYY) e6 CERTIFICATE OF LIABILITY INSURANCE I 02r28r2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). TACT PRODUCER 951-656-2409 951-281-3900 NME Patrick McCarrY dNF McCarry Insurance Services Lic. OD20867 [1P0CH_.No,Axl)�951-656 X409 (WjW:951-281-3900 19510 Van Buren Blvd. a{ass Prtc arhoommcrn.............mm.........................___. ... Ste. F3-142 .... INSURER(S)gAFFQRDINGCOVERAGE` ! wuca Riverside, CA 92508 INSURERA:United National Insurance Comp _V 13064 INSURED 310-548-9292 310-548-9195 mINSURERS:WeSCO Insurance Company 25011 'Berg &Associates, Inc. INSURERC:National Union Fire Insurance Co. 19445 dba: Berg Engineering Service INSURER D:Ins. Co. of the State of Pennsvlvan 19429 302 W. 5th Street, Suite 210 I.NSURER..E.,.,U.,.Se....S.Pecialty_L.nsurance C_o ?pany..............m...._...29599.,._ ,...... San Pedro. CA 90731 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:02 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE __�. "` -_._.. ___ ._.._( .._.__ .... .,. .. Iryl$}t_ . ADDi.$UBfF2 PO'LICY' 'FF�'+POLICY ExP LTR �IVn POLICY NUMBER {MMJODd'YYY'Yp (N4MI'DDrYYYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $1.Qo0.00Q,,,,_ A COMMERCIAL GENERAL LIABILITY D�GiCYkIcdlEtl_ CLAIMS-MADE ✓ OCCUR L7221 197-A 03/01/2019 03/01/2020 MED EXP(Any one nersonl $ 0 PERSONAL&ADV INJURY $1900 00 GENERAL AGGREGATE _$_,2 00AQ00 GEN"L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $Included POLICY' PER �'LOC $ AUTOMOBILE LIABILITY � ', �L I�,Ep11 SINGLE L11111T _t!1_ ,a.-_. W WPP1611478 01 03/01/2019 o3101r2o2o 1 Q�p 000__,.,__ B V( ANYAUTL') BODILY INJURY(Per person) $, ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ AUTOS ._.._..._.._.. _..., NON-OWNED ��'ROPERTY DA{MAGE HIRED AUTOS $ Medical $5.000 UMBRELLA LIAB OCCUR 03/01/2019 03/01/2020 EACH OCCURRENCE $9.000,000 C , Excessune CLAIMS.M{ADE BE 034215041 AGGREGATE $9,000,000 DED RETENTIONS0 r�yPr/rod/C.O. Aggreq. $9.000,000 ANY PROPRIETORIPARTNERIEXECCUTIVE E.L,,E H ACC DENT OT WORKERS COMPENSATION H. AND EMPLOYERS'LIABILITY —A -`CL1Mff'S ER_ Y r N 03/01/2019 03101/2020 $1 000 OQQ D OFFyFICERIMEMBER EXCLUDED? 1 NIA WC012332162-02 QQQ DESCRIPTION,OFOPERATIONS below E.I. DISEASE POLICYLIMIT.•..,,.1..QQQ,.�.Qt� .., (Mandatory ) OYES L Liability each claim, $1,000,000 E Professional Liability USS 19 29483 03101/2019 03/01/2020 iAggregate: $2,000,000 f DESCRIPTION OF OPERATIONSI LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more apace Is required) USL&H coverage included as part of above referenced workers compensation insurance policy. CERTIFICATE HOLDER CANCELLATION City of LI Segundo Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main St. ACCORDANCE WITH THE POLICY PROVISIONS. EI Segundo, CA 90245 AUTHORIZED REPRESENTATIVE ° / ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: L7221197-A COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES O CONTRACTORS - SCHEDULED F SO O ORGANIZATION This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s)Of Covered Operations City of EL Segundo officers, officials, employees, City of El Segundo agents, representatives and certified volunteers Public works 350 Main St. El Segundo, CA 90245 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage or personal and advertising injury "property damage"occurring after: caused, in whole or in part, by: 1. Your acts or omissions; or 1. All work, including materials, parts or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed;or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 2010 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section 111—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement;or Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 2010 0413 POLICY NUMBER: L7221197-A COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY ASI D NONCONTRIBUTORY - OT INSURANCE CONDITION ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance;and THIS ENDORSEMENT APPLIES TO THE FOLLOWING ENTITY: City of El Segundo officers, officials, employees, agents, representatives, and certified volunteers. CG 20 01 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: L7221197-A COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF FIGHT'S OF' RECOVERY AGAINST OTHERS TO HS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ALL WRITTEN CONTRACTS Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph S. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 POLICY NUMBER: WPP1611478 01 COMMERCIAL AUTO CA990187 0715 This Endorsement Changes The Policy. Please Read It Carefully BUSINESS UTO COVERAGE EXPANSION ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the COVERAGE FORM apply unless modified by the endorsement. A. Newly Acquired or Formed e. An"employee"of yours is an "insured" Organizations, Employee Hired Car while operating an "auto"hired or rented Liability and Blanket Additional Insured under a contract or agreement in that Status for Certain Entities. "employee's"name,with your Item 1.Who is an Insured of Paragraph A. permission, while performing duties Coverage under SECTION II—COVERED related to the conduct of your business. AUTOS LIABILITY COVERAGE is f. Any person or organization you are amended to add: required by written contract or d. Any organization you newly acquire or agreement to name as an additional form, other than a partnership,joint "insured", but only with respect to venture or limited liability company, and liability created in whole or in part by over which you maintain ownership of a such agreement. majority interest(greater than 50%),will B. Increase Of Loss Earnings Payment qualify as a Named Insured; however, Subpart(4)of a.Supplementary Payments (1) coverage under this provision is of Item 2. Coverage Extensions of afforded only until the 1801'day Paragraph A. Coverage under SECTION II after you acquire or form the —COVERED AUTOS LIABILITY organization or the end of the policy COVERAGE is amended to read: period, whichever is earlier; (4) We will pay reasonable expenses (2) coverage does not apply to "bodily incurred by the"insured"at our injury", "property damage"or request, including actual loss of "covered pollution cost or expense" earnings up to$1,000 per day that results from an"accident"which because of time off from work. occurred before you acquired or C. Fellow Employee Injured By Covered formed the organization; and Auto You Own Or Hire (3) coverage does not apply if there is Item 5. Fellow Employee of Paragraph B. other similar insurance available to Exclusions under SECTION II—COVERED that organization, or if similar AUTOS LIABILITY COVERAGE is insurance would have been amended to add: available but for its termination or the exhaustion of its limits of This exclusion does not apply if the"bodily insurance. injury"results from the use of a covered "auto"you own or hire. Such coverage as This insurance does not apply is afforded by this provision is excess over coverage for the newly acquired or any other collectible insurance. formed organization is excluded either by the provisions of this coverage form or by endorsement. CA990187 0715 Includes Copyrighted Material of Insurance Services Offices, Inc. Page 1 of 5 Used with permission D. Limited Automatic Towing Coverage G. "Personal Effects" Coverage Item 2.Towing, of Paragraph A.Coverage, Item 4.Coverage Extensions of Paragraph under SECTION III—PHYSICAL DAMAGE A. Coverage, under SECTION III- COVERAGE is amended to read: PHYSICAL DAMAGE COVERAGE,is amended to add: 2. Towing "Personal Effects" Coverage We will pay for towing and labor costs each time that a covered"auto" is We will pay actual cash value for"loss"to disabled. All labor must be performed at "personal effects"of the"insured"while in the place of disablement of the covered a covered"auto"subject to a maximum "auto". limit of$2,500 per"loss", for that covered "auto"caused by the same"accident". No a. The limit for towing and labor for deductible will apply to this coverage. each disablement is$500; H. "Downtime Loss" Coverage b. No deductible applies to this cover- age. Item 4. Coverage Extensions, of Paragraph A. Coverage, under SECTION E. Item 3. Glass Breakage—Hitting A Bird III. PHYSICAL DAMAGE COVERAGE, is Or Animal—Falling Objects or Missiles of amended to add: Paragraph A.Coverage under SECTION III —PHYSICAL DAMAGE COVERAGE, is "Downtime Loss" Coverage amended to add: We will pay any resulting "downtime loss" Glass Repair Coverage expenses you sustain as a result of a covered physical damage"loss"to a We will waive the Comprehensive covered "auto" up to a maximum of$100 deductible for Glass, if one is indicated on per day, for a maximum of 30 days for the your covered"auto", for glass repairs. We same physical damage"loss", subject to will repair at no cost to you, any glass that the following conditions: can be repaired without replacement, provided the"loss" arises from a covered a. We will provide"downtime Noss" beginning Comprehensive"loss"to your"auto". on the 5 day after we have given you F. Increase Of Transportation Expense our agreement to pay for repairs to a Coverage covered "auto and you have given the repair facility your authorization to make Subpart a.Transportation Expenses of repairs: Item 4.Coverage Extensions of Paragraph b. Coverage for"downtime loss" expenses A.Coverage under SECTION III— will end when any of the following occur: PHYSICAL DAMAGE COVERAGE is amended to read: (1) You have a spare or reserve"auto" available to you to continue your a. Transportation Expenses operations. We will pay up to$50 per day to a (2) You purchase a replacement"auto". maximum of$1,000 for temporary transportation expense incurred by you (3) Repairs to your covered"auto" have because of the total theft of a covered been completed by the repair facility "auto"of the private passenger type. and they determine the covered We will pay only for those covered "auto"is road-worthy. "autos"for which you carry either (4) You reach the 30 day maximum Comprehensive or Specified Causes of coverage. Loss Coverage or Theft Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered"auto"is returned to use or we pay for its"loss". CA990187 0715 Includes Copyrighted Material of Insurance Services Offices,Inc. Page 2 of 5 Used with permission I. Item 4. Coverage Extensions, of d. Contraband or property in the course Paragraph A. Coverage, under SECTION of illegal transportation or trade. Ill. PHYSICAL DAMAGE COVERAGE, is e. "Loss"caused by theft, unless there is amended to add: evidence of forced entry into the We will pay any resulting rental covered "auto"and a police report is reimbursement expenses incurred by you for filed. a rental of an "auto" because of"loss"to a K. Accidental Airbag Discharge Coverage covered "auto" up to a maximum of$100 per day, for a maximum of 30 days for the same Item 3.a. of Paragraph B. Exclusions under SECTION III—PHYSICAL DAMAGE physical damage"loss", subject to the following conditions: COVERAGE is amended to read: a. We will provide rental reimbursement a. Wear and tear, freezing, mechanical incurred during the policy period or electrical breakdown.The beginning 24 hours after the"loss"and exclusion relating to mechanical ending, regardless of the policy break-down does not apply to the expiration,with the number of days accidental discharge of an air bag. _ reasonably required to repair or replace L. Loan or Lease Gap Coverage the covered"auto". If the"loss"is Paragraph C. Limit Of Insurance under caused by theft, this number of days is SECTION III—PHYSICAL DAMAGE the number of days it takes to locate the COVERAGE is amended to add: covered"auto" and return it to you or the number of days it takes for the claim to If a covered"auto" is owned or leased and be settled,whichever comes first. if we provide Physical Damage Coverage b. Our payment is limited to necessary and on it, we will pay, in the event of a covered actual expenses incurred. total"loss", any unpaid amount due on the lease or loan for a covered "auto", less: c. This coverage does not apply while a. The amount paid under the Physical there are spare or reserve"autos" Damage Coverage Section of the available to you for your operations. policy; and d. If a"loss" results from the total theft of a b. Any: covered"auto" of the private passenger type,we will pay under this coverage (1) Overdue lease or loan only that amount of your rental payments including penalties, reimbursement expenses which is not interest or other charges already provided for under the Physical resulting from overdue Damage Coverage Extension. payments at the time of the J. "Personal Effects" Exclusion "loss"; Paragraph B. Exclusions under SECTION (2) Financial penalties imposed Ill—PHYSICAL DAMAGE COVERAGE, is under a lease for excessive use, amended to add: abnormal wear and tear or high mileage; "Personal Effects" Exclusion (3) Costs for extended warranties, We will not pay for"loss"to"personal Credit Life Insurance, Health, effects"of any of the following: Accident or Disability Insurance a. Accounts, bills, currency, deeds, purchased with the loan or evidence of debt, money, notes, lease; securities or commercial paper or (4) Security deposits not refunded other documents of value. by the lessor; and b. Bullion, gold, silver, platinum, or other (5) Carry-over balances from precious alloys or metals; furs or fur previous loans or leases garments;jewelry; watches; precious or semi-precious stones. c. Paintings, statuary and other works of art. CA990187 0715 Includes Copyrighted Material of Insurance Services Offices, Inc. Page 3 of 5 Used with permission M. Aggregate Deductible (3) An "executive officer"or director, if Paragraph D. Deductible under SECTION you are a corporation; III—PHYSICAL DAMAGE COVERAGE is (4) A manager or member, if you are a amended to add: limited liability company; Regardless of the number of covered (5) Your insurance manager, or "autos"involved in the same"loss", only (6) Your legal representative. one deductible will apply to that"loss". If the deductible amounts vary by"autos", P. Waiver Of Subrogation For Auto Liability then only the highest applicable deductible Losses Assumed Under Insured Contract will apply to that"loss". Item 5.Transfer Of Rights Of Recovery N. Diminishing Deductible Against Others To Us of Paragraph A. Paragraph D. Deductible under SECTION Loss Conditions under SECTION IV— BUSINESS AUTO CONDITIONS is III—PHYSICAL DAMAGE COVERAGE is amended to read: amended to add: Any deductible will be reduced by the 5. Transfer of Rights of Recovery percentage indicated below on the first Against Others To Us "loss"reported during the corresponding If any person or organization to or for policy period: whom we make payments under this Coverage Form has rights to recover damages from another, those rights are Loss Free Policy Periods Deductible transferred to us. That person or With the Expansion Reduction on the organization must do everything Endorsement first"loss" necessary to secure our rights and must 1 o% do nothing after an"accident" or"loss" 2 25% to impair them. However, if the insured has waived those rights to recover 3 50% through a written contract,we will waive 4 75% any right to recovery we may have 5 100% under this Coverage Form. If we pay a Physical Damage"loss" during Q. Insurance is Primary and the policy period under any BUSINESS Noncontributory AUTO COVERAGE FORM you have with Subpart a. of Item 5. Other Insurance of us, your deductible stated in the Paragraph B.General Conditions under Declarations page of each such SECTION IV—BUSINESS AUTO COVERAGE FORM will not be reduced on CONDITIONS is amended to read: any subsequent claims during the remainder a. This insurance is primary and of your policy period and your deductible reduction will revert back to 0% for each noncontributory, as respects any other such COVERAGE FORM if coverage is insurance, if required in a written contract with you. renewed. O. Knowledge of Loss and Notice To Us R. Other Insurance—Hired Auto Physical Damage Subsection a. of Item 2. Duties In the Event Subpart b. of Item 5..Other Insurance of of Accident, Claim, Suitor Loss of Paragraph A. Loss Conditions under Paragraph B. General Conditions under SECTION IV—BUSINESS AUTO SECTION IV--BUSINESS AUTO CONDITIONS is amended to add: CONDITIONS is amended to read: However, prompt notice of the"accident", b. For Hired Auto Physical Damage claim,"suit"or"loss"to us or our Coverage, the following are deemed authorized representative only applies to be covered "autos"you own: after the"accident", claim, "suit" or"loss"is (1) Any covered "auto"you lease, known to: hire, rent or borrow; and (1) You, if you are an individual; (2) A partner, if you are a partnership; CA990187 0715 Includes Copyrighted Material of Insurance Services Offices, Inc. Page 4 of 5 Used with permission (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's"name, with your permission, while performing duties related to the conduct of your business. However, any"auto"that is leased, hired, rented or borrowed with a driver is not a covered"auto". S. Unintentional Failure To Disclose Hazards Paragraph B. General Conditions under SECTION IV—BUSINESS AUTO CONDI- TIONS is amended to add: 9. Your failure fo disclose all hazards existing as of the inception date of this policy shall not prejudice the coverage afforded by this policy, provided that such failure to disclose all hazards is not intentional. However, you must report such previously undisclosed hazards to us as soon as practicable after its discovery. T. Additional Definition SECTION V—DEFINITIONS is amended to add: "Personal effects"means personal property owned by the"insured". "Downtime loss" means actual loss of "business income"for the period of time that a covered "auto": 1. Is out of service for repair or replacement as a result of a covered physical damage"loss"and 2. Is in the custody of a repair facility if not a total "loss". "Business Income"means: 1. Net Income (Net Profit or Loss before income taxes)that would have been earned or incurred; and 2. Continuing normal operating expenses incurred, including payroll. In this endorsement, Headinos and Titles are inserted solely for the convenience and ease of reference. They do not affect the coverage provided by this endorsement, nor do they constitute any part of the terms and conditions of this endorsement. All other policy wording not specifically changed, modified, or replaced by this endorsement wording remains in effect. CA990187 0715 Includes Copyrighted Material of Insurance Services Offices, Inc. Page 5 of 5 Used with permission BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is Issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 03/01/2019 forms a part of Policy No. WC 012-33-2162 Issued to BERG & ASSOC I ATES INC By THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium for this policy. WC 04 03 61 Countersigned b _ (Ed. 11/90) Authorized Representative